MyMedR

Fulltext The known unknowns of HPV natural history

Gravitt PE

J Clin Invest, 2011 Dec;121(12):4593-9.

The discovery that certain high-risk strains of human papillomavirus (HR-HPV) cause nearly 100% of invasive cervical cancer has spurred a revolution in cervical cancer prevention by promoting the development of viral vaccines. Although the efficacy of these vaccines has already been demonstrated, a complete understanding of viral latency and natural immunity is lacking, and solving these mysteries could help guide policies of cervical cancer screening and vaccine use. Here, we examine the epidemiological and biological understanding of the natural history of HPV infection, with an eye toward using these studies to guide the implementation of cervical cancer prevention strategies.

Matched MeSH terms: Immunocompromised Host

Fulltext Large Solitary Pulmonary Cryptococcoma Mimicking Lung Carcinoma in an Immunocompetent Patient

Anandpara KM, Aswani Y, Hira P

Malays J Med Sci, 2018 Feb;25(1):114-118.

PMID: 29599641 DOI: 10.21315/mjms2018.25.1.13

Cryptococcosis is a life-threatening mycosis typically seen in immunocompromised patients. Pulmonary cryptococcosis generally presents as multiple or solitary nodular opacities. Cryptococcal infection presenting as a destructing cavernoma (cryptococcoma) without diffuse infiltration of the lung is an extremely rare presentation, even in immunocompromised patients. This report presents a healthy, HIV negative, immunocompetent patient who presented with a large solitary lung mass provisionally diagnosed as a lung malignancy on radiological imaging that proved to be a large cryptococcoma after biopsy. The patient was treated with liposomal Amphotericin B and fluconazole, and the lesion showed regression on serial imaging. This case report thus highlights an unconventional presentation of pulmonary cryptococcosis in an immunocompetent individual.

Matched MeSH terms: Immunocompromised Host

Fulltext Herpes zoster in children with cancer

Menon BS, Wan Maziah WM

Malays J Pathol, 2001 Jun;23(1):47-8.

PMID: 16329548

The aim of this study was to determine the incidence and outcome of herpes zoster hospitalised children with cancer in Kota Baru. It was a retrospective review from January 1994 to December 1998. The diagnosis of herpes zoster was a clinical one. Herpes zoster was diagnosed in 10 of 188 (5%) children with malignancy. The most common malignancy was leukaemia. Nine children were treated with acyclovir. No child developed visceral dissemination and there were no deaths.

Matched MeSH terms: Immunocompromised Host

Fulltext Disseminated histoplasmosis mimicking miliary tuberculosis: a case report

Chan KS, Looi LM, Chan SP

Malays J Pathol, 1993 Dec;15(2):155-8.

PMID: 8065179

A 35-year-old Chinese man who was known to have insulin-dependent diabetes mellitus was admitted for fever and weight loss. During his hospital stay, he fell to his death from his ward at the twelfth floor. The clinical features, radiological findings and gross organ changes at autopsy closely simulated miliary tuberculosis. Histology, however, revealed extensive necrosis of the adrenal glands, lungs, spleen, kidneys and thyroid associated with the presence of Histoplasma capsulatum organisms. This case highlights the similarity both clinically and pathologically between histoplasmosis and tuberculosis and emphasizes the need to be aware of this infection in a nonendemic area among patients with a compromised immune system.

Matched MeSH terms: Immunocompromised Host*

Antibody deficiency with hyper IgM--a case report

Noh LM, Low SM, Lajin I, Abdullah N

Malays J Pathol, 1992 Dec;14(2):121-3.

PMID: 1304625

A 20-month-old Indian boy presented with recurrent pyogenic infections and failure to thrive. His IgG and IgA levels were low, but his IgM was elevated. He also had undetectable isohaemagglutinin titre and neutropenia, both parameters being poor prognostic indicators in this very rare primary immunodeficiency state--antibody deficiency with hyper IgM. Our patient subsequently succumbed to Pseudomonas aeruginosa septicaemia and meningitis inspite of aggressive antibiotic and intravenous gammaglobulin therapy. To the best of our knowledge, this is the first such case to be documented in Malaysia.

Matched MeSH terms: Immunocompromised Host*

Disseminated histoplasmosis mimicking an acute appendicitis

Marsilla MM, Khairunisa AA, Azyani Y, Petrick P

Malays J Pathol, 2019 Aug;41(2):223-227.

PMID: 31427560

INTRODUCTION: Histoplasmosis can present in a myriad of clinical manifestations, which often makes its diagnosis difficult and occasionally, deceptive.

CASE REPORT: We describe a case of a 33 years old gentleman who was clinically diagnosed as acute appendicitis at initial presentation in view of a one-week history of fever, right lower quadrant abdominal pain- and guarding at right iliac fossa. He had thrombocytopenia and lymphopenia on presentation. Mesenteric lymphadenitis and small bowel lesion were found intraoperatively, which was respectively biopsied and resected. Histopathological result confirms disseminated histoplasmosis. Retroviral screen was positive. He was treated with amphotericin B for one week, subsequently switched to oral itraconazole, followed by initiation of highly active antiretroviral therapy (HAART).

DISCUSSION: This case illustrates the various nature of histoplasmosis presentation. A high index of suspicion is needed to clinch the diagnosis and subsequently institute prompt treatment as disseminated disease can be fatal if left untreated in an immunosuppressed host.

Matched MeSH terms: Immunocompromised Host

Of "Cotton Balls" and "Owl's eyes"

Misra S, Gupta A, Saran RK

Malays J Pathol, 2020 Dec;42(3):487-490.

PMID: 33361734

Report of a 3-month old girl child who died due to multi-systemic infection of cytomegalovirus (CMV) involving the lungs, liver and kidneys along with pneumocystis jiroveci pneumonia (PJP). The mother of the child tested positive for CMV IgG and HIV with a very low CD4 count (160/ μl). Co-infection of cytomegalovirus and pneumocystis jiroveci always occurs in the setting of immunocompromise. Congenital CMV infection is transmitted through the placenta, especially during the first trimester and causes severe multi-systemic disease whereas perinatal infection is acquired during childbirth/ breastfeeding where the babies have maternal protective antibodies leading to much milder or asymptomatic infection. PJP is more common in infancy and presents as hypoxic pneumonia. CMV causes cyto-nucleomegaly and classic "owl's eye" inclusions on histology while PJP presents with characteristic fluffy "cotton ball" alveolar exudates.

Matched MeSH terms: Immunocompromised Host*

Fulltext The crucial role of molecular testing to facilitate the diagnosis of pneumocystis pneumonia during pregnancy

Ding CH, Yusoff H, Muttaqillah NAS, Tang YL, Tan TL, Periyasamy P, et al.

Malays J Pathol, 2018 Apr;40(1):69-72.

PMID: 29704387 MyJurnal

Pneumocystis pneumonia is an important human immunodeficiency virus (HIV)-associated opportunistic infection, and especially so in pregnant HIV-positive patients. We report a case of a 40-year-old woman in her first trimester of pregnancy who initially presented with acute gastroenteritis symptoms but due to a history of high-risk behaviour and the observation of oral thrush, she was worked up for HIV infection. Her retroviral status was positive and her CD4+ T cell count was only 8 cells/µL. She was also worked up for pneumocystis pneumonia due to the presence of mild resting tachypnoea and a notable drop in oxygen saturation (from 100% to 88%) following brief ambulation. Her chest radiograph revealed bilaterally symmetrical lower zone reticular opacities and Giemsa staining of her bronchoalveolar lavage (BAL) was negative for Pneumocystis jirovecii cysts. However, real-time P. jirovecii polymerase chain reaction (PCR) testing on the same BAL specimen revealed the presence of the organism. A course of oral co-trimoxazole plus prednisolone was commenced and her clinical condition improved.

Matched MeSH terms: Immunocompromised Host*

Fulltext Fusarium sp. infection in a patient with acute lymphoblastic leukaemia

Tan R, Ng KP, Gan GG, Na SL

Med J Malaysia, 2013 Dec;68(6):479-80.

PMID: 24632920 MyJurnal

In the past two decades, Fusarium species have been increasingly recognized as serious pathogens in immunocompromised patients. The outcome of fusariosis in the context of severe persistent neutropaenia has been almost universally fatal. The treatment of fusariosis in immunocompromised patients remains a challenge and the prognosis of systemic fusariosis in this population remains poor. This report presents a case of fatal fusariosis in a 37- year-old patient who was diagnosed with precursor-B cell Acute Lymphoblastic Leukaemia (ALL).

Matched MeSH terms: Immunocompromised Host

Fulltext Rhino-orbito-cerebral mucormycosis: a treatment dilemma

Jeevanan J, Gendeh BS, Faridah HA, Vikneswaran T

Med J Malaysia, 2006 Mar;61(1):106-8.

PMID: 16708746 MyJurnal

A case of rhino-orbito-cerebral mucormycosis is presented showing its aggressive nature and progression of disease. The typical clinical features, neuroimaging and histological findings are highlighted in this report. Amphotericin B and surgical debridement remain the mainstay of treatment. However, associated co-morbidities need to be addressed.

Matched MeSH terms: Immunocompromised Host

Fulltext Nocardia infection of the mastoid in an immunocompromised patient

Subha ST, Raman R

Med J Malaysia, 2004 Dec;59(5):688-9.

PMID: 15889577

A rare case of Nocardia infection of mastoid is presented in an immunocompromised patient.

Matched MeSH terms: Immunocompromised Host*

Fulltext Non-sporulating Chrysosporium: an opportunistic fungal infection in a neutropenic patient

Gan GG, Kamarulzaman A, Goh KY, Ng KP, Na SL, Soo-Hoo TS

Med J Malaysia, 2002 Mar;57(1):118-22.

PMID: 14569730

We report a case of an invasive infection with non-sporulating Chrysosporium species in a patient who was treated with chemotherapy for relapsed acute lymphoblastic leukemia. This patient presented with a persistent lobar pneumonia, skin lesions, and possible involvement of the central nervous system. The patient responded to treatment with amphotericin B and oral itraconazole.

Matched MeSH terms: Immunocompromised Host*

Fulltext The use of an in-house biotin-avidin linked immunosorbent assay to detect Aspergillus antigens in sera of immunocompromised patients

Abdul Samad S, Yusoff H, Fadilah SAW

Med J Malaysia, 2001 Mar;56(1):32-8.

PMID: 11503293

A biotin-avidin-linked immunosorbent assay was developed to detect Aspergillus antigens in sera of immunocompromised patients. The assay was based on a double antibody sandwich ELISA using polyclonal antibodies raised against water-soluble antigens of Aspergillus fumigatus. Aspergillus antigens were positive in sera of 9 of 16 (56%) patients who were studied prospectively and in 13 of 73 (19%) patients studied retrospectively. The 9 prospectively studied patients who were antigen positive were febrile neutropenic hematological malignancy patients who exhibited a high risk of acquiring invasive aspergillosis.

Matched MeSH terms: Immunocompromised Host

Fulltext Disseminated Geotrichum infection

Ng KP, Soo-Hoo TS, Koh MT, Kwan PW

Med J Malaysia, 1994 Dec;49(4):424-6.

PMID: 7674982

Intensive chemotherapy has prolonged survival in cancer patients. Unfortunately it has also predisposed them to unusual infections because of their immunocompromised state. We report a case of fungal septicaemia caused by Geotrichum candidum, an imperfect yeast of low virulence in a young girl with acute lymphoblastic leukaemia. It was successfully treated with amphotericin B. The morphological characteristics of this fungus leading to its identification are described.

Matched MeSH terms: Immunocompromised Host

Fulltext Varicella in children with haematological malignancy--outcome of treatment and prevention

Ho CM, Khuzaiah R, Yasmin AM

Med J Malaysia, 1994 Mar;49(1):29-35.

PMID: 8057987

Primary varicella-zoster virus infection in children with haematological malignancy is a life threatening disease. In one year, there were 10 cases of varicella and 2 cases of zoster among these children as well as 5 mothers who were accompanying their children who developed varicella in the oncology ward. Two children died of fulminating disease despite aggressive antiviral and supportive treatment. Acyclovir can be used in treatment and prophylaxis in exposed susceptible children. Varicella -zoster immune globulin is not available in this country. Vaccination with live virus has been shown to be protective in immunocompromised children and needs consideration.

Matched MeSH terms: Immunocompromised Host

Fulltext Scopulariopsis brevicaulis infection in a patient with acute myeloid leukemia

Ng KP, Soo-Hoo TS, Na SL, Gan GG, Sangkar JV, Teh AKH

Med J Malaysia, 2003 Oct;58(4):608-12.

PMID: 15190640

Scopulariopsis brevicaulis is a soil fungus normally associated with onychomycosis. It causes subcutaneous infection in immunocompromised patients and is rarely isolated from blood. A case of systemic Scopulariopsis brevicaulis infection was reported in a patient with acute myeloid leukemia. The patient developed persistent fever that did not respond to wide spectrum antibiotics and amphotericin B. Scopulariopsis brevicaulis was the only pathogen isolated from blood cultures. The fever subsided with itraconazole and there was no recurrence of fungal infection with prolonged maintenance of oral itraconazole.

Matched MeSH terms: Immunocompromised Host

Fatal outcome of catheter-related bloodstream infection caused by Multidrug-Resistant Mycobacterium mucogenicum

Faridah S, Siti Asma' H, Zeti NS, Tuan Noorkorina TK, Intan Baiduri B, Azura H

Med J Malaysia, 2021 03;76(2):248-250.

PMID: 33742638

Mycobacteria mucogenicum (M. mucogenicum) is a rarely isolated pathogen. It has emerged as a significant pathogen in immunocompromised patients including those with cancer, organ transplant, or patients on immunosuppressive medication. Chemotherapy may reduce the ability of the bone marrow of these to respond to infection, and patients will be at risk for neutropenic sepsis, which leads to fatal complications. Here, we report a case of an 18-year-old boy was seen at Hospital Raja Perempuan Zainab II, Kelantan with acute lymphoblastic leukaemia (ALL) who presented with catheter-related bloodstream infection (CRBSI) caused by M. mucogenicum. He succumbed due to neutropenic sepsis with multiorgan failure.

Matched MeSH terms: Immunocompromised Host

Subcutaneous mycosis presenting as a non- healing left calf ulcer in an immunocompromised patient

Tang ASO, Yong KY, Wong J, Chua HH, Chew LP

Med J Malaysia, 2017 04;72(2):122-123.

PMID: 28473676

This is a case report of subcutaneous mycosis presenting as a non-healing left calf ulcer in an immunocompromised patient. Traumatic inoculation of the causative agent is the most likely route of infection. The diagnosis requires a detailed history and high clinical suspicion, confirmed by histopathological examination. The management requires a multidisciplinary team approach involving surgeon, pathologist, physician sub-specialised in infectious disease, wound care nursing team as well as social support services. The literature review recommended that the treatment of choice for such infection is surgical debridement in addition to optimal antifungal therapy.

Matched MeSH terms: Immunocompromised Host*

Outcome of surgery of necrotising pneumonia in immunocompromised patients: HKL experience

Premjeet S, Narasimman S

Med J Malaysia, 2019 04;74(2):179-181.

PMID: 31079132

Necrotising pneumonia or lung gangrene is a challenging problem and it is diagnosed more often today, especially in tertiary hospitals. It is always a challenge to treat these patients as they are usually immunocompromised and are often ill when the diagnosis is made. We report three immunocompromised patients with necrotising pneumonia who were treated surgically. We share the outcomes of these patients and discuss the management of necrotising pneumonia in the immunocompromised.

Matched MeSH terms: Immunocompromised Host*

Detection of Cryptosporidium parvum in HIV-infected patients in Malaysia using a molecular approach

Zaidah AR, Chan YY, Asma HS, Abdullah S, Nurhaslindawati AR, Salleh M, et al.

Southeast Asian J. Trop. Med. Public Health, 2008 May;39(3):511-6.

PMID: 18564692

This cross-sectional study determined the prevalence of cryptosporidiosis in HIV-infected patients using polymerase chain reaction (PCR). Stool specimens were collected from HIV infected patients who were admitted to Hospital Raja Perempuan Zainab II, Kota Bharu, Malaysia, for various indications from December 2004 to December 2005. A modified acid-fast stain was performed on the direct stool smears, then the stool specimens were further tested using nested PCR targeting the 18S rRNA gene of Cryptosporidium parvum, with a built-in internal control (IC). Out of 59 samples, 11 were positives. Nested PCR identified a total of nine samples (16%) compared to microscopy, which identified only three samples. All PCR negative results showed IC amplicons, suggesting that these samples were true negatives and were not due to inhibition of PCR. This study highlights the importance of molecular diagnosis in determining the true prevalence and epidemiology of C. parvum.

Matched MeSH terms: Immunocompromised Host

Displaying publications 81 - 100 of 112 in total